MEDICAL ISSUES

Important information about medical issues.

Prescription medications.

Helpful OTC medications.

First Aid information.

 

Originally posted by SZ:

I am not recommending this to anyone but this is why I have Curcumin in my Pandemic Flu Stash.

As we all should know by now H5N1 appears to produce a "Cytokine Storm".  In my language that means the body turns on its immune system balls-to-the-wall and ends up literally killing what it is trying to save.  I am going to post a PubMed description of a cytokine storm.  Stay with me because the particulars (the bits) are important.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&a mp;a mp;db=PubMed&list_uids=8940690&dopt=Abstract

1: Nippon Geka Gakkai Zasshi. 1996 Sep;97(9):771-7.

Related Articles, < =1.2> < =1.2> Links

[Cytokine storm in the pathogenesis of multiple organ dysfunction syndrome associated with surgical insults]

[Article in Japanese]

Aikawa N.

Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan.

Multiple organ dysfunction syndrome (MODS) is a critical condition developing in the patients under overwhelming surgical insults such as a major surgery, severe trauma, extensive burn, and systemic sepsis. The host response to those surgical insults is the main pathogenetic factor contributing to the development of shock and MODS seen in surgical patients. The proinflammatory cytokines, TNF-alpha (TNF) and interleukin-1 beta (IL-1), are known to play a pivotal role in the pathogenetic mechanisms of MODS. In response to surgical insults, macrophages produce and release TNF and IL-1 which subsequently induce the production of other cytokines (IL-6, IL-8, etc.) and other endogenous chemical mediators (growth factors, adhesion molecules, complement cleavage products, thrombin, eicosanoids, PAF, nitric oxides, oxygen-free radicals, granulocyte elastase, etc.) The resultant systemic inflammation may develop into shock and MODS when the primary insults are overwhelming (early MODS) or a second inflammatory insult such as sepsis triggers an exaggerated inflammation. In the patients suffering from MODS, a systemic release of various cytokines is not properly regulated, and the high blood levels of the proinflammatory cytokines induce an autodestructive generalized inflammatory reaction. This condition is termed "Cytokine Storm" by the author. In the cytokine storm, not only proinflammatory cytokines but also anti-inflammatory cytokines are elevated in the blood stream. With the recent understanding of the biological and pathological roles of cytokines and other mediators, a new therapeutic strategy has been developed. In addition to the reduction of the surgical insults, a variety of anti-cytokine therapy and anti-mediator therapy has been tested in an attempt to prevent or treat the life-threatening MODS.

Publication Types:

• Review

PMID: 8940690 [PubMed - indexed for MEDLINE]

Now for the benefits of Curcumin:

https://enzy.com/abstracts/display.asp?id=1961

Medical Abstract Title:

Curcumin Inhibition of Inflammatory Cytokine Production by Human Peripheral Blood Monocytes and Alveolar Macrophages

Author:

Abe Y, Hashimoto S, Horie T

Source:

Pharmacol Res. 1999;39:41-47.

Abstract:

Curcumin, a dietary pigment responsible for the yellow colour of curry, has been used for the treatment of inflammatory diseases and exhibits a variety of pharmacological effects such as anti-inflammatory activity. The mechanism in anti-inflammatory activity of curcumin has been investigated; however, little is known about the effect of curcumin on cytokine production by human peripheral blood monocytes and alveolar macrophages. In the present study, we shed light on the effect of curcumin on inflammatory cytokine production by human peripheral blood monocytes and alveolar macrophages. To this end, we determined the concentrations of interleukin-8 (IL-8), monocyte inflammatory protein-1(MIP-1alpha), monocyte chemotactic protein-1 (MCP-1), interleukin-1beta (IL-1beta), and tumour necrosis factor-alpha (TNF-alpha) in the culture supernatants from phorbor ester, 4beta phorbor 12beta-myristate-13alpha acetate (PMA)- or lipo-polysaccharide (LPS)-stimulated monocytes and alveolar macrophages in the presence or absence of curcumin. Curcumin inhibited the production of IL-8, MIP-1alpha, MCP-1, IL-1beta, and TNF-alpha by PMA- or LPS-stimulated monocytes and alveolar macrophages in a concentration- and a time-dependent manner. These results show that curcumin exhibits an inhibitory effect on the production of IL-8, MIP-1alpha, MCP-1, IL-1beta, and TNF-alpha by PMA- or LPS-stimulated monocytes and alveolar (lung stuff*sz) macrophages. Now, remember I ain't recommending this for you or yours.  I expect you to trust in our medical community to be there, in full faith and force, if you find yourself in the terrible, beyond imagining, position of being exposed to or infected with Avian Influenza and not having a ready and handy stash of Tamiflu, the only recognized and medically sanctioned drug therapy for Avian Influenza

Originally posted by KillerFlu.net:

Black Elderberry: (Sambucol) A study in Israel in 1995 showed its effective against fighting the flu; It does so by increasing the production of inflammatory cytokines like IL-1, IL-6, and TNF. (citation also below) the

 

clinical trial in Israel showed that a preparation not only ended cases of the flu within three days, but increased antibody production. (I believe all these studies have been conducted on Natures Way Sambucol)

The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines.

Barak V, Halperin T, Kalickman I.

Immunology Laboratory for Tumor Diagnosis, Department of Oncology, Hadassah University Hospital, Jerusalem, Israel.

Sambucus nigra L. products - Sambucol - are based on a standardized black elderberry extract. They are natural remedies with antiviral properties, especially against different strains of influenza virus. Sambucol was shown to be effective in vitro against 10 strains of influenza virus. In a double-blind, placebo-controlled, randomized study, Sambucol reduced the duration of flu symptoms to 3-4 days. Convalescent phase serum showed a higher antibody level to influenza virus in the Sambucol group, than in the control group. The present study aimed to assess the effect of Sambucol products on the healthy immune system - namely, its effect on cytokine production. The production of inflammatory cytokines was tested using blood - derived monocytes from 12 healthy human donors. Adherent monocytes were separated from PBL and incubated with different Sambucol preparations i.e., Sambucol Elderberry Extract, Sambucol Black Elderberry Syrup, Sambucol Immune System and Sambucol for Kids. Production of inflammatory cytokines (IL-1 beta, TNF-alpha, IL-6, IL-8) was significantly increased, mostly by the Sambucol Black Elderberry Extract (2-45 fold), as compared to LPS, a known monocyte activator (3.6-10.7 fold). The most striking increase was noted in TNF-alpha production (44.9 fold). We conclude from this study that, in addition to its antiviral properties, Sambucol Elderberry Extract and its formulations activate the healthy immune system by increasing inflammatory cytokine production. Sambucol might therefore be beneficial to the immune system activation and in the inflammatory process in healthy individuals or in patients with various diseases. Sambucol could also have an immunoprotective or immunostimulatory effect when administered to cancer or AIDS patients, in conjunction with chemotherapeutic or other treatments. In view of the increasing popularity of botanical supplements, such studies and investigations in vitro, in vivo and in clinical trials need to be developed.

PMID: 11399518 [PubMed - indexed for MEDLINE]

RESEARCH

A variety of research data from studies conducted around the world have proven Sambucol® to be effective in shortening the duration of the flu and lessening flu symptoms. Below are some research highlights:

Effect of Sambucol® on several strains of Influenza virus

Sambucol®, a standardized extract, is a preparation based on the berries of the black elder, used as herbal remedy for influenza virus infections. It contains a potent antiviral compound, AntiVirin® as well as a high amount of three flavonoids (Bronnum-Hansen and Hansen, 1983). The flavonoids are naturally occurring plant antioxidants.

Laboratory Tests

Sambucol® reduced hemagglutination and inhibited replication of human influenza virus type A, type B and animal strains from swine and turkeys in cell cultures.

Clinical Study

A double-blind placebo-controlled clinical study was conducted during an outbreak of influenza B Panama. A significant improvement of the symptoms, including fever, was seen in 93.3% of the cases in Sambucol® treated group within 2 days. A complete cure was achieved within 2 to 3 days in nearly 90% of the Sambucol® treated group and within at least 6 days in the placebo group. "Inhibition of Several Strains of Influenza Virus in Vitro and Reduction of Symptoms by an Elderberry Extract (Sambucus nigra L) during an Outbreak of Influenza B Panama", Z. Zakay-Rones et al. J. Alt Compl Med 1:361-369;1995.

other studies also, but lost the info.

 

Originally posted by Mary Kay:

Inserting a nasogastric tube:

You will need:

A gastric tube, water based lubricant, a stethoscope, a 50cc syringe, paper tape, non sterile gloves, small container of warm water, cup of water with straw, and 30cc's of sterile water for testing.

1. Measure the tubing from nose, down neck, to stomach area. This will tell you how far to go down with the tube. Note this line.{Tubing will have several lines on it.} This is not a sterile procedure, but should be as clean as possible. There are two basic tube sizes, child's and adult. Prepare two pieces of tape, 1 1/2 inches long.
2. Sit patient in an upright position only, tilt head back very slightly, 5 degrees.
3.With gloves on, warm tube in warm water so it is pliable. You don't want it stiff as this will make insertion more difficult, and painful.
4. Using a water based lubricant, or if none is available use water, lubricate the first 8 or 9 inches well so it will slide in easily, bend the tubing so it has a curve.
5.Give the patient the cup of water with a straw and tell them that they are to sip through the straw when you tell them.
6. Hold the tube at the first three inches, insert straight about an inch, then immediately bend downward, as that goes down about three inches, then ask the patient to start drinking the water through the straw, proceed in passing the tube, about two inches at a time per second. You will feel a SLIGHT resistance,keep going, then it should go right down without further difficulty. If the patient starts gagging, stop.Open mouth and see if the tube detoured through mouth. Remove tube, try again in a few minutes. The patient may be anxious so be patient. This is not rocket science. Anyone can do this so be confident and patient.
7. When the line of measurement is at the nose, stop. Then you can have someone hold the tube at the nose or tape it while you check for placement.
8.Take the syringe, draw back on the stopper and fill syringe with air. Place syringe over the end of tube, place stethoscope over the stomach, inject air quickly. If the tube is properly placed you will hear a "swissssh" of air, absolutely. It will be loud and distinct. If you do not hear this, try again, if no sound, remove tube. Never introduce fluids if you fail to hear this as it may be in the lungs.
9. After you are certain of it's placement you can introduce the warm sterile water, 30cc's, wait a minute. Then pull back to remove the fluid. If the fluid is yellowish, gastric fluids, then you know it's for sure in. {If patient should start coughing, lip color is cynotic/bluish, remove tube, it's not in the stomach but the lungs.}
10. Secure with tape.
11. Introduce sterile water only at first to be on the safe side, in case it's in the lungs. Then give food, ensure or whatever fluids your DOCTOR recommends.Fluids may be given via slow drip/ 60 cc's per hour,per bag or "bolus" with syringe, 240 cc's over five minutes. Patients {adult}are usually fed four/five times a day, with 120/150cc water with each feeding. If patient is a diabetic, you must check blood sugar and feed appropriately according to blood sugar levels.
12. NEVER, ever, feed a patient while they are lying flat. There is the chance of aspiration into the lungs.
Always keep bed up, at least a 40 degree angle during feeding time and for the following 45 minutes post feeding.
13. Follow feeding with 30cc's of water to flush tubing.
14. Start every feeding with 30cc's of water to clear the tubing.
15. Most meds may be crushed and given with fluids.Check before crushing any med. Heart and narcotic meds usually can not be crushed.
Tube may remain for several days/weeks.
16. Check for proper placement each and every time you introduce fluids.
17. Remember electrolytes are important.

Mary Kay RN

Originally posted by Fla_Medic:

An ambu-bag (don't leave home without out one), can be used to assist ventilation.  I've kept one in my personal first aid kit for 25 years, and it has come in handy.

It does, however, require someone to operate it.   A patient might be kept  alive through a respiratory crisis using one, but this could become a long siege.  Still, if the manpower is available, I would be tempted to use one.  This technique has been used in ICU's when the ventilators malfunctioned or the power goes out.

There are perils, however.  Without an intubation tube, there is a good chance that with prolonged application, air will be delivered to the stomach as well as the lungs.  This can result in the patient vomiting and aspirating the stomach contents into the lungs. 

There are generally three ways to provide an `airway' to the lungs when using an ambu-bag. The best is an endotrachial tube, but inserting one is a skill that a lay person is unlikely to aquire.  Second best is an esophageal obturator, which is easier to insert, but still requires training.  Both of these can prevent inflating the stomach and subsequent aspiration.

The third type is a simple oropharengeal airway.  A curved plastic tube that slips into the mouth and over the tongue.  It's quick, easy, and can improve the delivery of air to the paitent. It, however, does not isolate the stomach, and therefore does not prevent aspiration.

This type of airway is the one the lay person is most likely to have access to, and have the ability to use. 

You should also be aware that starting this sort of assisted ventilation is easy.  The decision to discontinue it is not.  There may come a point in time where the manpower is unavailable, or the patient's condition continues to deteriorate, where that decision must be made.  It is never easy to `call' a code and discontinue life saving efforts.  To do so to someone in your family would be much tougher.

That said, I would personally opt to use one if I felt the patient had a chance of recovery.  I would, howver, be fully aware that this could be an exercise in futility. 

Think forward to what medical exam procedures you might need, or want, as routine or prospective diagnostic proceducres such as colonoscopies, EKGs, or many other forms of examinations one never really considers may not be available, who knows, for a couple, or several years, are hard to find.

Be careful of Black Elderberry, My opinion.
My family won't be using it!!!!

Black Elderberry

Trade name: Sambucol (cached)        &nbs p;    

history
There is evidence that black elderberry extract (trade name: Sambucol) can reduce the risk of contracting ordinary influenza strains, or shorten the course of disease in those who contract the typical flu.

It does so by increasing the production of inflammatory cytokines like IL-1, IL-6, and TNF. PMID:12455180 (cache). PMID:11399518
While black elderberry extract be appropriate for ordinary Type A influenza, it could make avian flu more lethal. Ordinary strains of flu do not trigger massive production of TNF, and ordinary flu viruses are generally susceptible to the action of TNF. Avian flu, by contrast, does trigger massive production of TNF (as much as a 45x increase), while the virus is relatively resistant to the anti-viral effects of TNF. If TNF is a significant cause of the illness and mortality in avian flu, anything that increases TNF would be undesirable.
It has been pointed out that black elderberry does not just increase TNF and other cytokines. It also may reduce the spread of the virus through inactivation, or exert anti-inflammatory effects as well as contributing to the cytokine storm. It may be that combining elberberry with other anti-inflammatories may allow it to check the infection without producing tissue destroying levels of cytokines. But there is insufficient evidence to make a solid conclusion, while there are significant red flags that should be raised about the mode of action of elderberry.


Edited by Enumclaw,WA

Welcome Nomadcrna!  Looking forward to your posts and opinions.  Let us know if you have any questions.

  Hi Asatrape, I am in the same situation wil you do me a favor and PM me the pharamacies you used over seas.  Had you used them before?  If you don't mind me asking how many months are you stock piling for?  I would like to get a general idea of what to plan for.  Thanks a lot.

My family's doctors will not give us the scripts to stock up on our meds.

I saw somewhere on here a recipe for make your own electrolyte mix.  It called for "salt substitute"  What is this and where can I find it?? 

I purchased electrolytes to mix with water in a small little kit convient for hikers.  (My kids sometimes feel/are dehydrated even after drinking adequate amounts of gatoraid.)   Purchased it over the net at some site advertising it for sports.  The homemade electrolyte mix someone was talking about I am pretty sure consisted of salt & sugar added to water.  I don't remember the percentagess.  But at least one day I remember shopping for extra salt, sugar and basting tubes just in case I had to force liquids down some really sick person.